National Provider Identifier [NPI]: |
1801861299 |
Last Name Of The Provider |
MCKENNA |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15761 NEW HAMPSHIRE CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339084176 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
2782 |
Number Of Medicare Beneficiaries |
970 |
Total Submitted Charge Amount |
998679.04 |
Total Medicare Allowed Amount |
315906.46 |
Total Medicare Payment Amount |
232146.82 |
Total Medicare Standardized Payment Amount |
212030.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
2782 |
Number Of Medicare Beneficiaries With Medical Services |
970 |
Total Medical Submitted Charge Amount |
998679.04 |
Total Medical Medicare Allowed Amount |
315906.46 |
Total Medical Medicare Payment Amount |
232146.82 |
Total Medical Medicare Standardized Payment Amount |
212030.03 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
442 |
Number Of Beneficiaries Age 75 to 84 |
326 |
Number Of Beneficiaries Age Greater 84 |
152 |
Number Of Female Beneficiaries |
529 |
Number Of Male Beneficiaries |
441 |
Number Of Non Hispanic White Beneficiaries |
907 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
896 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.0944 |